A Pharma Company Role in Medical Literature

If you’ve ever worried that pharmaceutical companies have too much sway when it comes to determining your treatment, today’s news won’t help quell your fears.

The New York Times reports that a large pharmaceutical developer hired ghostwriters to “play a major role in producing” 26 scientific papers that support hormone replacement therapy (HRT) in women. The papers were then published in medical journals between 1998 and 2005, without acknowledging the pharmaceutical-company backing. “Because physicians rely on medical literature,” the Times article claims, “the concern about ghostwriting is that doctors might change their prescribing habits after reading certain articles.”

For its part Wyeth — the company in question — claims that the articles were based entirely on sound science. (The company also now has a clear policy, the Times reports, that its role be acknowledged on all research it funds. That policy began in 2006, according to the newspaper.) HRT was indeed used for decades to treat symptoms of menopause, and doctors did genuinely believe that the treatment was helpful — that by boosting estrogen levels women could avoid heart disease. Then in 2002, results from a large clinical trial showed that the therapy probably does more harm than good. Most women stopped using it.

The Times says it was lawyers currently suing Wyeth over HRT who uncovered the documents about ghostwriting. The court documents were then made public after a court request from both the Times and the public-access medical journal, PLoS Medicine.

The newspaper writes:

“The ghostwritten papers were typically review articles, in which an author weighs a large body of medical research and offers a bottom-line judgment about how to treat a particular ailment. The articles appeared in 18 medical journals, including The American Journal of Obstetrics and Gynecology and The International Journal of Cardiology.”

Hence the concern that doctors would be swayed.

The Times article further suggests that a medical communications firm would write the articles, and that academic researchers would later put their names to them — often, the newspaper insinuates, with only minor changes.

It seems then that, if any wrongdoing in fact occurred, researchers and journals may want to share some of the blame. Journals have been upping their standards for conflict-of-interest declarations in recent years. That’s clearly a step in the right direction.